2004年和2014年长沙城区肺结核合并肺癌流行病学比较分析

目的:分析2004年和2014年长沙城区肺结核合并肺癌患者性别、年龄、吸烟史、肺结核分型、肺癌病理类型的差异,了解近年来长沙城区肺结核合并肺癌的流行趋势。方法:统计分析长沙市中心医院2004年和2014年收治的长沙城区肺结核合并肺癌患者的临床资料。结果:与2004年相比,2014年肺结核合并肺癌患者人数较前明显增加,老年、男性、吸烟为高危因素。 结论:十年来,肺结核合并肺癌人数增加,流行趋势未见明显变化。     

肿瘤防治咨询者吸烟相关知识的调查分析

摘 要：［目的］ 了解肿瘤防治咨询者对吸烟相关知识的知晓情况。［方法］ 统一培训调查员,用匿名方式对参加肿瘤防治咨询活动的人员进行控烟知识的问卷调查。［结果］ 439名调查对象中,男性242名,女性197名;非吸烟者377名,曾经吸烟者62名。调查对象知晓控烟知识的总知晓评分为62.43。按性别、咨询角色、受教育程度、吸烟史、家庭成员吸烟史分组统计的总知晓评分差异无统计学意义;50岁以下年龄组的总知晓分（71.88～72.88）高于50岁以上年龄组（62.36～68.68）,差异有统计学意义。调查对象对12项吸烟可导致疾病问题上,知晓率高于60%的有6项,包括吸烟可导致肺癌（93.39%）、肺病（89.07%）、口腔和鼻咽部恶性肿瘤（80.41%）、喉癌（76.16%）、冠心病（73.58%）、食管癌（61.73%）;知晓率低于60%的有6项,包括吸烟可导致宫颈癌（44.65%）、膀胱癌（45.79%）、胰腺癌（46.47%）、肾癌（47.15%）、肝癌（55.13%）和胃癌（56.26%）。对4项避免或减少因暴露烟草而危害健康的问题,调查对象的知晓率均低于25%,包括仅下决心未必能成功戒烟（5.69%）、低焦油、低尼古丁的烟不会减少对人体的危害（16.40%）、低焦油、低尼古丁的烟不会减少患病风险（18.00%）、电子烟不能帮助戒烟（24.15%）。［结论］ 控烟宣传亟需细化和精准,尤其是吸烟导致的各种疾病和有效的戒烟方法。     

Smoking behavior following diagnosis in patients with Stage I non-small cell lung cancer

The cigarette-smoking behavior of 840 patients with resected Stage I non-small cell lung cancer was analyzed prospectively for up to four years following diagnosis. Lung cancer patients were heavier smokers at diagnosis than other cancer patients and the general population. At one year, only 16.8 percent of the 317 current smokers at baseline, who were followed for two years or longer, continued to smoke, while 83.2 percent of patients either quit permanently (53.0 percent) or for some time period (30.2 percent). By two years, permanent cessation stabilized at over 40 percent; however, the prevalence of continuing smoking decreased through all periods of follow-up. Subjects who tried to quit or did quit permanently were more likely to be female and healthier than continuous smokers.This research was supported in part by grants CA 43461, CA-16042, and CA-3417 from the National Cancer Institute.     

Active and passive smoking and the risk of breast cancer in women aged 36-45 years: a population based case-control study in the UK

Active smoking has little or no effect on breast cancer risk but some investigators have suggested that passive smoking and its interaction with active smoking may be associated with an increased risk. In a population based case-control study of breast cancer in women aged 36-45 years at diagnosis, information on active smoking, passive smoking in the home, and other factors, was collected at interview from 639 cases and 640 controls. Women were categorised jointly by their active and passive smoking exposure. Among never smoking controls, women who also reported no passive smoking exposure were significantly more likely to be nulliparous and to be recent users of oral contraceptives. Among those never exposed to passive smoking, there was no significant association between active smoking and breast cancer, relative risk (RR) of 1.12 (95% confidence interval (CI) 0.72-1.73) for past smokers and RR of 1.19 (95% CI 0.72-1.95) for current smokers, nor was there an association with age started, duration or intensity of active smoking. Compared with women who were never active nor passive smokers, there was no significant association between passive smoking in the home and breast cancer risk in never smokers, RR of 0.89 (95% CI 0.64-1.25), in past smokers, RR of 1.09 (95% CI 0.75-1.56), or in current smokers, RR of 0.93 (95% CI 0.67-1.30). There was no trend with increasing duration of passive smoking and there was no heterogeneity among any of the subgroups examined. In this study, there was no evidence of an association between either active smoking or passive smoking in the home and risk of breast cancer.     

The cumulative risk of lung cancer among current, ex- and never-smokers in European men

Recent analyses based on UK data indicate that people who stop smoking, even well into middle age, avoid most of their subsequent risk of lung cancer. We investigated whether similar absolute risks of lung cancer in men are found in other European countries with different smoking patterns and at different stages of their lung cancer epidemic. Using data for men from a multicentre case-control study of lung cancer in the UK, Germany, Italy and Sweden, and including 6523 lung cancer cases and 9468 controls, we combined odds ratio estimates with estimates of national lung cancer incidence rates to calculate the cumulative risk of lung cancer among men by age 75. Lung cancer cumulative risks by age 75 among continuing smokers were similar for the UK, Germany and Italy at 15.7, 14.3 and 13.8% respectively, whereas the cumulative risk among Swedish male smokers was 6.6%. The proportion of the risk of lung cancer avoided by quitting smoking before the age of 40 was comparable between the four countries, at 80% in Italy and 91% in the UK, Germany and Sweden. Similarly, the proportion of the excess risk avoided by quitting before the age of 50 ranged from 57% in Italy to 69% in Germany. Our results support the important conclusion that for long-term smokers, giving up smoking in middle age avoids most of the subsequent risk of lung cancer, and that lung cancer mortality in European men over the next three decades will be determined by the extent to which current smokers can successfully quit smoking.     

Lung bullae and pulmonary fibrosis associated with marijuana smoking

A 26‐year‐old man with a history of heavy marijuana and minimal tobacco use was found to have extensive bilateral lung bullae and interstitial fibrosis, heavily infiltrated by pigmented macrophages. These features can be associated with marijuana smoking. The differential diagnoses in this patient are also discussed.     

Breast cancer incidence in relation to smoking cessation

High plasma levels of oestrogens are associated with increased breast cancer risk. If smoking, as has been suggested, have both a tumour initiating mutagenic effect and a protective anti-oestrogenic effect, one would assume that smokers who give up smoking have the highest incidence of breast cancer. This was evaluated in the follow-up of a cohort of 10,902 women of whom 4,359 were premenopausal. Record-linkage with official cancer registries yielded 416 incident cases during an average follow-up of 13.6 years. The adjusted relative risk in all ex-smokers was 1.31 (1.02–1.69), as compared to never smokers, and in premenopausal ex-smokers it was 1.57 (1.07–2.30). Breast cancer incidence in premenopausal ex-smokers was inversely related to time since cessation, (p for trend=0.01), and was highest among the women who had given-up smoking less than 12 months before screening: 2.76 (1.55–4.91). There was no significant association between current smoking and breast cancer risk. We conclude that incidence of breast cancer in premenopausal women who have given up smoking is higher than it is in smokers and never smokers. To what extent this may be related to endocrine effects associated with smoking cessation remains to be evaluated.     

Occupational Risk Factors for Lung Cancer in Men and Women: A Population-Based Case–Control Study in Italy

OBJECTIVE: We investigated the role of occupation in lung cancerogenesis in two Northern Italian areas. METHODS: During 1990-1992, occupational histories were obtained for 1171 incident lung cancer cases (956 men, 176 women) and 1553 population controls (1253 men, 300 women) and were evaluated for having been employed in jobs entailing exposure to known or suspected lung carcinogens. A further exploratory analysis on other job titles and branches of industry was conducted. RESULTS: Among men, we found a smoking-adjusted odds ratio (OR) of 2.1 (95% confidence interval: 1.6-2.8) for exposure to known carcinogens, corresponding to a population attributable risk of 9.5% (6.0-13.0). Non-ferrous metal workers and painters had a significantly increased risk. No association was found for exposure to suspected carcinogens. In the exploratory analysis, the OR was increased for cleaners (OR: 2.7; 1.0-7.4), bakers (5.7; 1.4-24), tailors (6.9; 1.2-39), plumbers and pipe fitters (2.6; 1.0-6.4), welders and flame-cutters (5.6; 2.1-15), dockers and freight handlers (1.7; 1.0-2.7) and construction workers (1.4; 1.1-1.9). Female glass workers, laundry/dry cleaners and workers in rubber industry had an increased risk. CONCLUSIONS: The study indicates that a sizable proportion of lung cancers among men may be due to occupational exposures and suggests that exposure to lung carcinogens occurs in different jobs in women compared to men.